This report is a clinical review of 58 patients suffering from frostbite, who were treated at the department orthopedic surgery, Seoul City Dong Bu Hospital from November 1982 to March 1985. The results are as follows: 1. The male to female sex ratio was 13.5:l. 2. The majority of the patients (72%) were decades between 30 and 50. 3. Frostbite began on November and registered the highest incidence in January, the lowest temperature of the year. 4. The most commonly affected region was the lower extremities, bilaterally. 5. The average duration of exposure in cold weather was 23 days, 6. The average hospitalization period was 84 days. 7. Among the 58 patients, 14 patients were treated by conservative treatment, 14 patients by closed amputation and 25 patients by open amputation.
Amputation ; Clinical Study ; Female ; Frostbite ; Hospitalization ; Humans ; Incidence ; Lower Extremity ; Male ; Orthopedics ; Seoul ; Sex Ratio ; Weather

BACKGROUND: Polyarteritis nodosa(PAN) is a disease of necrotzing vasculitis which has a clinical spectrum encompassing those cases of multisystem involveme it and skin-limited variant. The clinical course of cutaneous PAN has been considered to be a benign one, however there is sorne controversy regarding its nosological entity. OBJECTIVE: To characten the clinical course of the patients with cutaneous PAN and determine whether or not it is a benign disease or something more sever. METHODS: Clinical and laboratory findings in 8 patients with Logy-proven cutaneous PAN but without any detectable visceral involvement were observed periochelly during a follow-up period over 18 months. Meticulous physical and pertinent laboratory earinations were performed each time during their visits. RESULTS: Livedo reticulari, on the lower legs was the mostorenon cutaneous findings with these patients. During the follow-up periods there were no suspected abnormal physical and laboratory findings to have other organ involvement in all 8 patients Serologic examinations for antineutrophil cytoplasmic antibody and hepatitis-B surface antigen revealed negative in all patients tested. CONCLUSION: The follow-up periods of 2 years or so does not seem to be long enough in characterizing the clinical features of PAN. However, the cutaneous: on of PAN can be regarded as a benign cutaneous variant of the disease having no visceral lesion of arteritis, even though mild degrees of constitutional symptoms and a few laboratory abnormlites could be seen.
Antibodies, Antineutrophil Cytoplasmic ; Antigens, Surface ; Arteritis ; Follow-Up Studies ; Humans ; Leg ; Polyarteritis Nodosa* ; Vasculitis

A 40-year-old woman had a pruritic, vesiculobullous eruption of her face for 6 weeks with no evidence of systemic disease. A biopsy showed subepidermal blisters and dermal infiltrates of neutrophilic inflammatory cells. Direct immunofluorescence demonstrated thick linear deposits of IgG and C3 along the basement membrane zone. The cleavage plane was identified to be just beneath the lamina densa. Using Western immunoblots, the patient's IgG autoantibodies were found to recognize type VII proeollagen. Moderate starting doses of systemic prednisolone gave a good response for this patient with an early inflammatory form of epidermolysis bullosa acquisita.
Adult ; Autoantibodies ; Basement Membrane ; Biopsy ; Blister ; Blotting, Western ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Neutrophils ; Prednisolone

To evaluate the differentiation status of smooth muscle in gastric stromal tumors which were negative for S-100 protein, immunohistochemistry using desmin, actin, myosin and vimentin was performed in 14 cases of gastric smooth muscle tumors. Ultrastructural Examination was also performed. For comparison a case of leiomyoma of the esophagus, a case of the sigmoid colon, 10 cases of the uterus were also examined. The results obtained were as follows. All gastric smooth muscle tumors showed vimentin-positivity. Six of 14 gastric smooth muscle tumors, (5 of 8 leiomyoma and 1 of 4 leiomyosarcoma) showed positivity for desmin, actin, and myosin(42.9%). All esophageal, colonic, and uterine leiomyomas showed diffuse positive reaction for desmin, actin, and myosin. Vimentin positivity was also noted in leiomyoma of the colon and uterus. Ultrastructurally, a few cells in the gastric stromal tumors had scattered microfilaments with dense bodies, subplasmalemmal dense plaques, and micropinocytic vesicles. However, most of the tumor cells did not have any of the ultrastructural features of smooth muscle differentiation. Leiomyomas of the esophagus and uterus showed many cytoplasmic microfilaments with dense bodies. These results suggest that most of the benign and malignant tumor cells of gastric stromal tumors have features of the undifferentiated cells, immunohistochemically as well as ultrastructurally, although a few cells have. It is speculated that most gastric stromal tumors may have lost their smooth muscle differentiation.

BACKGROUND: Epidurally administered clonidine represents an approach to control the pain after cesarean section that produces analgesia by an alpha 2-adrenergic mechanism and may provide postoperative analgesia without nausea, pruritus, and respiratory depression associated with systemic or intraspinal opioid administration. This study was undertaken to evaluate the analgesic effect according to the dose of appropriate bolus and the combination of epidural morphine and clonidine after cesarean section. METHOD: Forty five women, ASA physical status 1 or 2, scheduled for elective cesarean section were randomly assigned to receive epidural administration for postoperative pain control. Group A (n=15) received 1 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 150 g clonidine. Group B received 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine. Group C received 3 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 450 g clonidine. Each combination of drug was injected at Bromage scale 1 after surgery. RESULTS: All groups showed relatively stable hemodynamic status. Analgesic effect was significantly better in Group B and C than Group A (p<0.05). Sedative effect was not a problem in all groups. The incidence of side effects in Group C was more than Group B, which than Group A, but almost cases did not require treatment. CONCLUSION: 2 mg morphine and 75 g clonidine bolus followed by 4 mg morphine and 300 g clonidine with excellent analgesic effect and less side effects is considered as adequate dose in postoperative pain control after cesarean section with epidural anesthesia.
Analgesia ; Anesthesia, Epidural* ; Cesarean Section* ; Clonidine* ; Female ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pregnancy ; Pruritus ; Respiratory Insufficiency

No abstract available.
Humans ; Hyperthyroidism* ; Procollagen*

No abstract available.
46, XX Disorders of Sex Development* ; Adrenal Hyperplasia, Congenital* ; Female* ; Humans

Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

We present a patient who developed granuloma in a previous herpes zoster scar (post-zoster granuloma). The development of granuloma in healed herpes zoster lesions may represent an atypical delayed hypersensitivity reaction to viral antigens or tissue antigens altered by the virus. To our knowledge, this is the first case reported in Korean literature.
Antigens, Viral ; Cicatrix ; Granuloma* ; Herpes Zoster ; Humans ; Hypersensitivity, Delayed

Neurofibrosarcoma is the most common malignant change in patients with neurofibromatosis. But the incidence of neurofibrosarcoma arising from cutaneous neurofibroma is very low. We report two cases of neurofibrosarcoma arising from cutaneous neurofibroma in patients with neurofibromatosis showing typical clinical manifestations.
Humans ; Incidence ; Neurofibroma* ; Neurofibromatoses* ; Neurofibrosarcoma*